An unusual presentation of ischaemic mitral regurgitation as P2 prolapse
A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary arter...
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| Veröffentlicht in: | Perfusion 2017-11, Vol.32 (8), p.706-708 |
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| creator | Thompson, David S. Punjabi, Prakash P. |
| description | A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop. Additionally, the P2 scallop was deficient in chordae from the posteromedial PPM, thus, loss of this accessory head led to severe mitral regurgitation. We review the PPM anatomy and pathological context of PPM rupture and ischaemic mitral regurgitation. |
| doi_str_mv | 10.1177/0267659117720989 |
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Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop. Additionally, the P2 scallop was deficient in chordae from the posteromedial PPM, thus, loss of this accessory head led to severe mitral regurgitation. We review the PPM anatomy and pathological context of PPM rupture and ischaemic mitral regurgitation.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/0267659117720989</identifier><identifier>PMID: 28703036</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Anatomy ; Angiography ; Coronary artery ; Coronary vessels ; Edema ; Electrocardiography ; Humans ; Ischemia ; Male ; Middle Aged ; Mitral Valve Insufficiency - complications ; Occlusion ; Papillary Muscles - surgery ; Prolapse ; Regurgitation ; Rupture ; Ultrasonic imaging</subject><ispartof>Perfusion, 2017-11, Vol.32 (8), p.706-708</ispartof><rights>The Author(s) 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c318t-18743de50dd772c80c25a6f32f0e0df46dd59c5b24a35add35a33caf8000e59a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0267659117720989$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0267659117720989$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28703036$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thompson, David S.</creatorcontrib><creatorcontrib>Punjabi, Prakash P.</creatorcontrib><title>An unusual presentation of ischaemic mitral regurgitation as P2 prolapse</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). 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We review the PPM anatomy and pathological context of PPM rupture and ischaemic mitral regurgitation.</description><subject>Anatomy</subject><subject>Angiography</subject><subject>Coronary artery</subject><subject>Coronary vessels</subject><subject>Edema</subject><subject>Electrocardiography</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral Valve Insufficiency - complications</subject><subject>Occlusion</subject><subject>Papillary Muscles - surgery</subject><subject>Prolapse</subject><subject>Regurgitation</subject><subject>Rupture</subject><subject>Ultrasonic imaging</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1LAzEQxYMotlbvnmTBi5fVyeZjs8dS1AoFPSh4W9Jktm7Zj5psDv73prSKFLxkAvN7bx6PkEsKt5Tm-R1kMpei2P4zKFRxRMaU53lKKX0_JuPtOt3uR-TM-zUAcM7ZKRllKgcGTI7JfNoloQs-6CbZOPTYDXqo-y7pq6T25kNjW5ukrQcXAYer4Fb1ntA-ecmiqG_0xuM5Oal04_FiPyfk7eH-dTZPF8-PT7PpIjWMqiGlKufMogBrY2ajwGRCy4plFSDYiktrRWHEMuOaCW1tfBgzulIxPIpCswm52fnGw58B_VC2MSc2je6wD76kBVWKS6pkRK8P0HUfXBfTRUoKIYEJFSnYUcb13jusyo2rW-2-SgrlttnysOUoudobh2WL9lfwU2sE0h3g9Qr_XP3P8Btdt4OD</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Thompson, David S.</creator><creator>Punjabi, Prakash P.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>An unusual presentation of ischaemic mitral regurgitation as P2 prolapse</title><author>Thompson, David S. ; Punjabi, Prakash P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c318t-18743de50dd772c80c25a6f32f0e0df46dd59c5b24a35add35a33caf8000e59a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anatomy</topic><topic>Angiography</topic><topic>Coronary artery</topic><topic>Coronary vessels</topic><topic>Edema</topic><topic>Electrocardiography</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mitral Valve Insufficiency - complications</topic><topic>Occlusion</topic><topic>Papillary Muscles - surgery</topic><topic>Prolapse</topic><topic>Regurgitation</topic><topic>Rupture</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thompson, David S.</creatorcontrib><creatorcontrib>Punjabi, Prakash P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thompson, David S.</au><au>Punjabi, Prakash P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An unusual presentation of ischaemic mitral regurgitation as P2 prolapse</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2017-11</date><risdate>2017</risdate><volume>32</volume><issue>8</issue><spage>706</spage><epage>708</epage><pages>706-708</pages><issn>0267-6591</issn><eissn>1477-111X</eissn><abstract>A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). 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| fulltext | fulltext |
| identifier | ISSN: 0267-6591 |
| ispartof | Perfusion, 2017-11, Vol.32 (8), p.706-708 |
| issn | 0267-6591 1477-111X |
| language | eng |
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| source | MEDLINE; SAGE Complete |
| subjects | Anatomy Angiography Coronary artery Coronary vessels Edema Electrocardiography Humans Ischemia Male Middle Aged Mitral Valve Insufficiency - complications Occlusion Papillary Muscles - surgery Prolapse Regurgitation Rupture Ultrasonic imaging |
| title | An unusual presentation of ischaemic mitral regurgitation as P2 prolapse |
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